Analysis on the Therapeutic Scheme for One Case of Refractory Infections with Clinical Pharmacists' Consultation_West China Medical Journal

Authors：

 ZhengGaofeng , YueXiaohui

Department of Pharmacy, People's Hospital of Jianyang City, Jianyang, Sichuan 641400, P R. China;

Corresponding?author：

Keywords：

Clinical pharmacist; Pharmacy consultation; Refractory infections; Analysis of therapeutic scheme

DOI：

10.7507/1002-0179.201600142

Video：

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Objective To discuss the practical methods of clinical drug therapy with clinical pharmacists' participation. Method The patient was male and at the age of 88. Because of "exertional heart tiredness for 4 years, coughing sputum for 10 days, and sudden inarticulate condition", he was admitted into the hospital on November 22nd, 2013. The diagnosis was cerebral infarction with pulmonary infection. Clinical pharmacists participated in the consultation on February 19th, 2014 because the uncontrollable repeated pulmonary infection. By analyzing the therapeutic scheme, clinical pharmacists made and adjusted the treatment scheme for one patient with refractory infections. Results After the treatment scheme was adjusted, several laboratory test results of the patient returned to normal, including respiratory rate, body temperature, white blood cell count and neutrophils. Sputum volume decreased obviously and sputum culture was negative. Lung signs and image were significantly improved. Conclusions Clinical pharmacists should pay more attention to the analysis of the clinical therapeutic scheme to improve therapeutic efficacy for patients with refractory infections.

Citation： ZhengGaofeng, YueXiaohui. Analysis on the Therapeutic Scheme for One Case of Refractory Infections with Clinical Pharmacists' Consultation. West China Medical Journal, 2016, 31(3): 541-544. doi: 10.7507/1002-0179.201600142 Copy

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1. 薛曉燕, 王明麗. 臨床藥師參與2例泛耐藥鮑曼不動桿菌感染患者的治療實踐[J]. 中國藥房, 2013, 24(34) :3251-3253.
2. 胡曉蕾, 詹世鵬, 王渝, 等. 臨床藥師參與1例肺部重癥感染患者治療方案的調整[J]. 中國藥房, 2013, 24(26) :2491-2494.
3. 李鐘勇, 何清華. 臨床藥師參與158例感染性疾病會診的調查分析[J]. 中南藥學, 2011, 9(7) :552-554.
4. 蔡少華. 重癥肺炎的抗生素降階梯治療策略和國內的臨床實踐[J]. 中國藥物應用與監測, 2007, 4(2) :1-3.
5. 聶垚, 管向東. 重癥感染的初始治療:"重錘猛擊"策略的再認識[J]. 中華內科雜志, 2015, 54(8) :677-679.
6. 裴保香, 龔虹霖. 卡泊芬凈和伊曲康唑治療侵襲性肺部真菌感染的回顧性分析[J]. 中國藥物應用與監測, 2012, 9(6) :314-316.
7. 葉曉光, 王若倫, 林紅燕, 等. 產超廣譜β-內酰胺酶肺炎克雷伯菌、大腸埃希菌耐藥譜動態觀察[J]. 中華醫院感染學雜志, 2004, 14(5) :492-495.
8. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; twenty-third informational supplement[S]. CLSI, 2013:M100-S23.
9. 張麗華, 尚謙, 于慶萍. 第三代頭孢菌素的用量與大腸埃希菌、肺炎克雷伯菌耐藥相關性分析[J]. 中國藥師, 2006, 9(3) :260-262.
10. 鄒自英, 楊繼勇, 朱冰, 等. 大腸埃希菌耐藥性分析及生物被膜形成能力研究[J]. 中華醫院感染學雜志, 2012, 22(18) :3934-3937.
11. 中華醫學會呼吸病學分會感染學組. 2013銅綠假單胞菌下呼吸道感染診治專家共識[J]. 中華結核和呼吸雜志, 2014, 37(1) :9-15.
12. 謝景超. 老年肺部感染抗菌藥物治療失敗原因的論述[J]. 中國感染控制雜志, 2009, 8(2) :73-76.
13. 陳佰義. 抗感染治療中"降階梯治療策略"臨床實踐的幾點思考[J]. 中華內科雜志, 2011, 50(6) :453-455.
14. 中華醫學會重癥醫學分會. 重癥患者侵襲性真菌感染診斷與治療指南(2007) [J]. 中華內科雜志, 2007, 46(11) :960-966.
15. 廖雪蓮, 康焰. 重癥感染治療:治菌還是治病[J]. 中華內科雜志, 2015, 54(8) :672-674.

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West China Medical Journal

Analysis on the Therapeutic Scheme for One Case of Refractory Infections with Clinical Pharmacists' Consultation

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